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目的探讨吉西他滨联合卡铂方案(GC方案)与超液化碘油乳剂治疗Ⅲ期肝细胞癌的疗效及安全性。方法61例Ⅲ期肝细胞癌患者采用GC方案与超液化碘油乳剂化疗栓塞治疗。治疗方案为卡铂300 mg/m~2行肝动脉灌注,结合吉西他滨1000 mg/m~2和超液化碘油5～30 ml混合成乳剂栓塞。参照WHO抗癌药物毒性分级标准观察毒性反应,Child-Pugh分级观察肝脏损害。随访患者生存期。结果本组CR 0例,PR 37例,SD 13例,PD 11例,总有效率60.7%。61例患者的血液学毒性表现为骨髓抑制作用,中性粒细胞计数下降,其中Ⅰ度占39.3%,Ⅱ度占29.5%,Ⅲ～Ⅳ度占18.0%。恶心呕吐Ⅱ～Ⅲ度占96.8%。肝脏Child-Pugh分级显示,术后16例由A级升至B级,2例由A级升至C级,6例由B级升至C级。随访61例患者的生存期为5～35个月,中位生存期20个月。结论GC方案联合超液化碘油乳剂化疗栓塞治疗Ⅲ期肝细胞癌是安全有效的,能够改善患者的生活质量。
Objective To investigate the efficacy and safety of gemcitabine combined with carboplatin (GC) and lipiodol emulsion in the treatment of stage Ⅲ hepatocellular carcinoma. Methods Sixty-one patients with stage Ⅲ hepatocellular carcinoma were treated with chemotherapy and embolization with ultra-liquefied lipiodol emulsion. The treatment regimen consisted of hepatic arterial infusion of carboplatin 300 mg / m ~ 2, combined with gemcitabine 1000 mg / m ~ 2 and ultra-liquefied lipiodol 5 ~ 30 ml into emulsion embolism. Toxicity was observed according to WHO standard of toxicological classification of cancer drugs. Child-Pugh grading was used to observe liver damage. Follow-up patient survival. Results The group CR 0 cases, PR 37 cases, SD 13 cases, PD 11 cases, the total effective rate 60.7%. The hematological toxicity of 61 patients showed myelosuppression and decreased neutrophil count. Among them, Ⅰ degree accounted for 39.3%, Ⅱ degree 29.5%, Ⅲ ~ Ⅳ 18%. Nausea and vomiting Ⅱ ~ Ⅲ degree accounted for 96.8%. Liver Child-Pugh grading showed that 16 cases rose from A to B after operation, 2 from C to C, and 6 from B to C after operation. Follow-up 61 patients with survival of 5 to 35 months, the median survival of 20 months. Conclusion GC regimen combined with ultra-liquefied lipiodol emulsion chemoembolization in the treatment of stage III hepatocellular carcinoma is safe and effective, which can improve the quality of life of patients.